The Democratic Alliance has unveiled its alternative plan for universal healthcare in South Africa, via a full policy document titled ‘Our Health Plan (OHP)’.

The political party says its health plan will provide quality healthcare to all South Africans within 5-8 years.

“We believe our offer is the most credible and workable option that seeks to ensure that no person is denied quality healthcare because they are poor,” said DA shadow minister of health, Dr Wilmot James.

The DA said its policy would replace the current National Health Insurance (NHI) system, should it be voted into power. “It can be rolled out sooner; it is far more affordable; it is fairer; and aspects of it have already been shown to work in practice,” James said.

For South Africans who have no medical aid, the DA said its reforms will deliver improved service at clinics and hospitals, enhanced maternal and child care provision and access to efficient – and free at the point of service – emergency services in urban and rural areas.

“Those who are on medical aid will benefit from enhanced choice and greater access to more efficient – and free at the point of service – ambulance services,” James said.

The DA promised faster delivery of its health plan (5-8 years) versus the NHI which it said will take 10-15 years to implement.

“Our Health Plan will provide quality healthcare to all at a cost that we as a country can easily afford. It can be implemented using our current health budget, but with an additional R6 billion achieved by bringing the current medical aid tax credit of R17 billion on budget.

“This would mean that medical aid contributions would no longer be tax deductible. However, the remaining R11 billion of additional revenue would go to reducing the costs of medical aid. The NHI on the other hand is budgeted to cost up to an additional R182 billion per year, which we simply cannot afford,” James said.

The political party said that much of its proposed plan has already been implemented in the Western Cape.

The DA highlighted the following ‘salient’ proposals contained in its proposed health plan:

  • Provide an additional R1 billion per year towards the training of medical, nursing and health professional staff;
  • Provide an additional R2 billion per year for expanded maternal and child healthprogrammes for which clinics and hospitals that qualify compete;
  • Provide an additional R1 billion for a single number national public-private emergency service governed by an independent board;
  • Reform the medical schemes so that they compete on the cost and quality of the health services they cover, rather than on the risk groups they target;
  • Establish a self-funded post-retirement and unemployment protection regime for medical aid members;
  • Set aside an indicative R9.43 billion from the medical aid tax credits to reduce the monthly contributions of medical scheme members;
  • Reform the Council of Medical Schemes (CMS) to have a board that is independent of the Minister of Health and the entities it (the CMS) regulates;
  • Introduce autonomous public hospitals and district health authorities governed by independent boards and with wide operational discretion allocated to executive heads to carry out their mandates;
  • Insist on having clinically trained chief executives of hospitals and managers of health facilities;
  • Extend nationally the Western Cape’s reliance on inter-sectoral collaboration with non-governmental organisations (NGOs), private companies (Clicks), pharmacists, private physiotherapists, general practitioners (GPs) and complementary medicine and allied healthcare professionals;
  • Extend nationally the Western Cape’s system of having three service streams (1) home and community based services provided by community health care workers; (2) intermediate care; and (3) primary health clinics, community health centres and day centres;
  • Provide for expanded clinic-building programmes especially for under-served areas nationwide by devoting an additional R2 billion per year to building and staffing clinics;
  • Allocate a universal subsidy to every South African citizen and legal resident, irrespective of whether or not they are covered by the public or private health systems. The value of the subsidy would be set in relation to an affordable and comprehensive package of services available within the public health system;
  • Propose state sponsored reinsurance for small medical schemes;
  • Ensure health provision will be free at point of service for both those who have medical aid membership and those who do not. Medical schemes will pay in a more structured manner for public services used by their members as the quality thereof improves. R2 billion of the medical tax credit revenue is made available for this purpose; and
  • Eliminate the funding gap for those who fail the means test but cannot afford medical aid, by eliminating the means test itself.

“This entire plan is realizable within our current resource envelope meaning we can achieve universal healthcare for all, without requiring any new or additional taxes,” James said.

The full document can be accessed here


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